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VISION member awarded UKDS Impact Fellow to study violence and mental health impacts in older age

    Dr Anastasia Fadeeva

    VISION Research Fellow, Dr Anastasia Fadeeva, has been awarded a UK Data Service (UKDS) Fellowship.

    Anastasia’s interest and education in medicine increased her awareness of the impact of social determinants on people’s health. This led to an MSc in Public Health at London Metropolitan University followed by a PhD at Northumbria University and a career in health services and public health research.

    As a UKDS Fellow, Anastasia will look at the issues of violence in older age, the long-term impacts of violence on mental health, and the lack of reliable data.

    For more information about Anastasia and her work, see her blog on the UKDS website or email her at anastasia.fadeeva@citystgeorges.ac.uk.

    The UKDS is funded by the UKRI and houses the largest collection of economic, social and population data in the UK. Its Data Impact Fellowship scheme is for early career researchers in the academic or the voluntary, community, and social enterprise (VSCE) sector. The purpose of the programme is to support impact activities stemming from data-enhanced work. For further information on the UK Data Service please see: UK Data Service

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    The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

      Child maltreatment (CM) and parental domestic violence and abuse (pDVA) impose considerable lifelong adverse outcomes on those affected. Approximately 8.5 million adults in England and Wales are estimated to have been exposed to CM (physical, sexual or emotional abuse or emotional or physical neglect of a child by a parent or caregiver) before their 16th birthday. Despite sharing multiple family and environmental risk factors, the economic burden of child exposure where they co-occur has not previously been estimated in detail.

      VISION researcher Professor Gene Feder estimated average lifetime societal costs resulting from CM or childhood exposure to pDVA, and incremental costs for scenarios where they co-occur with lead researcher Dr Kevin Gilbert at the University of Cambridge and others.

      The findings showed that lifetime costs for childhood exposure to CM and/or pDVA, were £71,309 per child (non-fatal exposure), and £1,292,377 per CM fatality, with £27.8 billion projected costs (2013 UK birth cohort).

      Total costs for exposure to pDVA alone was £1.0 billion (£16,639 per child exposed), rising to £2.0 billion (£71,037 per exposed child) for children reporting awareness of pDVA. Co-occurring CM and pDVA imposed greater costs than either alone, including costs from child perpetration of intimate partner violence.

      As a result of the research the team concluded that CM and/or pDVA exposure incurs large personal and societal economic burdens. Costs from both pDVA exposure and intergenerational transmission of IPV perpetration highlight the importance for policies to address both CM and domestic violence and abuse in affected households.

      Given the scale of burden accrued over the life course after CM and/or pDVA exposure, this model can provide a framework upon which policy makers can identify the best use of resources to maximise the societal benefits from the effective interventions needed to tackle a complex social issue.

      To download the article: The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK

      To cite: Herbert K, Feder G, Gilbert R, Powell C, Howarth E, Morris S. The economic burden of child maltreatment and co-occurring parental domestic violence and abuse in the UK. Child Abuse Negl. 2025 Mar 31;163:107435. doi: 10.1016/j.chiabu.2025.107435. Epub ahead of print. PMID: 40168916.

      For further information, please contact Kevin at kch28@medschl.cam.ac.uk

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      Evaluation of a domestic violence training and support intervention in Palestinian primary care clinics in the west bank: a mixed method study

        Domestic violence (DV) is a violation of human rights and a major public health problem that damages the health of women and their families. In the occupied Palestinian territories, 29% of women have a lifetime exposure to intimate partner violence, the most prevalent form of DV.

        Despite the existence of national policies to prevent and respond to DV, implementation within the Palestinian primary health care system has been weak. The research team, including VISION researcher Professor Gene Feder, developed, piloted, and evaluated a system-level intervention, including training for health care providers and care pathways for women patients. The aim of the evaluation was to determine the feasibility and acceptability of the HEalthcare Responding to violence and Abuse (HERA) intervention.

        The adaptation of a previous (HERA) intervention was implemented in primary health care
        settings in Palestine, informed by stakeholder meetings, interviews with clinic managers and health care providers (HCP), facility-level readiness data, and findings of a previous pilot study. The training component of the intervention, delivered by the Palestinian Counseling Centre, included a train-the-trainer session, two clinic-based training sessions, and reinforcement sessions for front-line healthcare providers in four clinics.

        Healthcare providers were trained to ask about DV, give immediate support, and offer a referral to a nurse case manager. The care pathway beyond the case manager was either referral to a primary-care based psychologist or social worker or to a gender-based violence focal point external to the clinic that coordinated referrals to appropriate external services (e.g. police, safe house, psychologist, social worker).

        For the evaluation, the researchers employed a thematic analysis of post-intervention semi-structured interviews with HCP and trainers, and observations of training sessions and field notes. Provider Intervention Measure (PIM) data on changes in HCP attitudes and practice were analysed with descriptive statistics. Identification and referral rates for women disclosing DV 12 months before and 12 months after the intervention were obtained from clinic registries. The research team also developed a theory of change to triangulate the qualitative and quantitative data.

        Results showed that the training proved acceptable to HCPs and there was evidence of positive change in attitudes and readiness to engage with women patients experiencing DV. Compared to the year before the intervention, there was a reduction in the number of patients disclosing DV during the intervention and of referrals in three of the four clinics. This reduction may be explained by the impact of the Covid 19 pandemic on clinic priorities, lack of time, persisting HCP fear about engaging with DV, and HCP rotation between clinics.

        The delivery of the training component of the HERA intervention within the Palestinian primary
        healthcare system proved partly feasible and was acceptable to HCPs, but contextual factors limited HCP implementation of the training in practice.

        To download the article: Evaluation of a domestic violence training and support intervention in Palestinian primary care clinics in the west bank: a mixed method study

        For further information, please contact Nagham at naghamjoudeh@gmail.com

        Multiple adverse childhood experiences and mental and physical health outcomes in adulthood: New systematic review protocol assessing causality

          Research suggests that adverse childhood experiences can have a lasting influence on children’s development that result in poorer health outcomes in adulthood. Like other exposure-outcome relationships, however, there is uncertainty about the extent to which the relationship between adverse childhood experiences and health is causal or attributable to other factors.

          The aim of this systematic review is to better understand the nature and extent of the evidence available to infer a causal relationship between adverse childhood experiences and health outcomes in adulthood.

          A comprehensive search for articles will be conducted in four databases (Medline, CINAHL, PsycInfo and Web of Science) and Google Scholar. The team, led by Dr Lisa Jones of Liverpool John Moores University, and includes VISION researchers Professor Mark Bellis and Professor Sally McManus, will review studies published since 2014:

          • of adults aged 16 years or over with exposure to adverse childhood experiences before age 16 years from general population samples;
          • that report measures across multiple categories of childhood adversity, including both direct and indirect types; and
          • report outcomes related to disease morbidity and mortality.

          To download the protocol: Interpreting evidence on the association between multiple adverse childhood experiences and mental and physical health outcomes in adulthood: protocol for a systematic review assessing causality

          To cite: Jones L, Bellis MA, Butler N, et al. Interpreting evidence on the association between multiple adverse childhood experiences and mental and physical health outcomes in adulthood: protocol for a systematic review assessing causality. BMJ Open 2025;15:e091865.  doi: 10.1136/bmjopen-2024-091865

          For further information, please contact Lisa at l.jones1@ljmu.ac.uk

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          Systematic review: Effectiveness of UK-based adult domestic and sexual violence support interventions and services

            Recommendations

            • Further high-quality research into the effectiveness of domestic and sexual violence and abuse (DVSA) interventions and evaluations of perpetrator programmes are required, including randomised controlled studies where appropriate and ethical, to improve certainty regarding the effect estimates generated from evidence syntheses. Published protocols, adherence to reporting guidelines, such as CONSORT, STROBE and SQUIRE 2.0, and considering and accounting for confounding factors where randomisation is not feasible, will strengthen the research.
            • Developing a core outcome set via co-production with survivors, practitioners and service providers, commissioners, policy makers and researchers will increase consistency in reported outcomes and create the cohesion necessary to develop a robust evidence base to aid understanding of how effective various support services are.

            In the United Kingdom, there are a range of support services and interventions for people who have experienced domestic and sexual violence and abuse (DSVA), including refuges, advocacy such as Independent Domestic Violence Advisors (IDVAs), referral, outreach, and helplines. These are often provided by the Voluntary and Community Sector (VCS), although may also be located in the public or private sector. Due to the lack of consensus on outcomes used to assess effectiveness, evidence syntheses in this field have been limited.

            Dr Sophie Carlisle led a team of VISION researchers, Dr Annie Bunce, Prof Sally McManus, Dr Estela Capelas Barbosa, Prof Gene Feder, and Dr Natalia V Lewis, and Prof Matthew Prina from Kings College London. They used findings from their scoping review to identify the common reported outcomes, to direct and inform an evidence synthesis on the effectiveness of UK-based interventions and services for DSVA.

            The team conducted a systematic review and, where possible, meta-analysis. They searched relevant peer reviewed and grey literature sources. The following were included: randomised controlled trials, non-randomised comparative studies, pre-post studies, and service evaluations of support interventions or services for adults who had experienced or perpetrated DSVA. The intervention typology and selection of outcomes was determined based on co-production with stakeholders from specialist DSVA organisations. The quality of the studies was assessed independently by two reviewers. Where meta-analysis was not possible, the researchers synthesized studies with vote counting based on the direction of effect.

            The review demonstrates that there appear to be benefits of UK-based advocacy and outreach services, psychological support interventions, and perpetrator programmes. However, risk of bias and methodological heterogeneity means that there is uncertainty regarding the estimated effects.

            A co-produced core-outcome set is needed to develop a more robust evidence base and facilitate future research in this field. Research practices such as publishing of study protocols, following reporting guidelines and, for research where randomisation is not feasible, considering and accounting for potential confounding factors, would greatly improve the quality of research.

            To download the paper: Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: a systematic review and meta-analysis – PMC

            To cite: Carlisle S, Bunce A, Prina M, McManus S, Barbosa E, Feder G, Lewis NV. Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: a systematic review and meta-analysis. BMC Public Health. 2025 Mar 14;25(1):1003. doi: 10.1186/s12889-025-21891-5. PMID: 40087589; PMCID: PMC11908015.

            For further information, please contact Sophie at sophie.carlisle4@nhs.net

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            Physical health conditions and intimate partner violence: A gendered issue

              Intimate partner violence (IPV) is a widespread global public health issue with serious and long-lasting consequences. While much research has focused on the mental health consequences of IPV, such as depression and PTSD, there is limited evidence on its association with physical health.

              This study explored how different types and number of types of IPV are linked to specific physical health conditions, and whether these associations differ between men and women. VISION researchers Dr Ladan Hashemi, Dr Anastasia Fadeeva and Professor Sally McManus, with Nadia Khan, City St George’s UoL, examined this using data from the 2014 Adult Psychiatric Morbidity Survey.

              Key findings include:

              • Women were more likely to experience IPV and a higher number of IPV types than men.
              • Women’s experience of lifetime and 12-month IPV were significantly associated with 12 and 11 different physical health conditions, respectively, while men’s experience of lifetime and 12-month IPV were significantly associated with 4 and 1 conditions, respectively.
              • Different types of IPV types were associated with different types of physical health condition, particularly among women.
              • A cumulative association between experiencing a greater number of IPV types and an increased risk of physical health conditions was evident for women but not for men.

              The research concludes that IPV is a gendered issue, with stronger associations between IPV and physical health evident in this data for women than for men. This may be because women are more likely to experience more and multiple types of IPV, more frequently, and more often with injury. Healthcare systems must recognise IPV as a priority issue, ensuring support is tailored to those affected.

              Recommendation

              • Healthcare systems need to address IPV as a priority health issue for the female population. Gender-informed approaches in IPV intervention strategies and healthcare provision are required. This means emphasising the development of IPV-responsive healthcare systems and comprehensive IPV curricula in medical and health training.

              To download the paper: Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey – Ladan Hashemi, Anastasia Fadeeva, Nadia Khan, Sally McManus, 2025

              To cite: Hashemi L, Fadeeva A, Khan N, McManus S. Intimate partner violence and physical health in England: Gender stratified analyses of a probability sample survey. Women’s Health. 2025;21. doi:10.1177/17455057251326419

              For further information, please contact Ladan at ladan.hashemi@citystgeorges.ac.uk

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              Synthetic datasets enable linkage and a longitudinal understanding of experiences of violence and health impacts and consequences

                Violence is a complex social problem and a public health issue, with implications for the health and social care systems, police and justice systems, as well as significant productivity losses for those who experience it. Analysing data collected by these systems can aid understanding of the problem of violence and how to respond to it. In social research, analysing administrative records together with survey data has already enabled better measurements of violence and its costs, capturing experiences of both victim-survivors and perpetrators across multiple points in time and social and economic domains.

                Ideally, data from the same individuals would enable linkage and a longitudinal understanding of experiences of violence and their (health) impacts and consequences. However, most studies in violence-related research analyse data in silo due to difficulties in accessing data and concerns for the safety of those exposed. This is particularly the case for data from third sector specialist support services for victims or perpetrators of violence which has, to VISION’s knowledge, not been linked or combined with other datasets. Because these services provide person-centred trauma-informed care and there is a risk that information on their service users may be used against them in courts or by immigration authorities, direct data linkage is not possible and alternatives are needed.

                With this research, VISION researchers Dr Estela Capelas Barbosa, Dr Niels Blom, and Dr Annie Bunce provide a proof-of-concept synthetic dataset by combining data from the Crime Survey for England and Wales (CSEW) and administrative data from Rape Crisis England and Wales (RCEW), pertaining to victim-survivors of sexual violence in adulthood. Intuitively, the idea was to impute missing information from one dataset by borrowing the distribution from the other.

                The researchers borrowed information from CSEW to impute missing data in the RCEW administrative dataset, creating a combined synthetic RCEW-CSEW dataset. Using look-alike modelling principles, they provide an innovative and cost-effective approach to exploring patterns and associations in violence-related research in a multi-sectorial setting.

                Methodologically, they approached data integration as a missing data problem to create a synthetic combined dataset. Multiple imputation with chained equations were employed to collate/impute data from the two different sources. To test whether this procedure was effective, they compared regression analyses for the individual and combined synthetic datasets for a variety of variables.

                Results show that the effect sizes for the combined dataset reflect those from the dataset used for imputation. The variance is higher, resulting in fewer statistically significant estimates. VISION’s approach reinforces the possibility of combining administrative with survey datasets using look-alike methods to overcome existing barriers to data linkage.

                Recommendations

                • Imputing missing information from one dataset by borrowing the distribution from the other should be applicable for costing exercises as it permits micro-costing. 
                • Compared to traditional research, VISION’s proposed approach to data integration offers a cost-effective solution to breaking (data-related) silos in research.

                To download the paper: Look-alike modelling in violence-related research: A missing data approach | PLOS One

                To cite: Barbosa EC, Blom N, Bunce A (2025) Look-alike modelling in violence-related research: A missing data approach. PLoS ONE 20(1): e0301155. https://doi.org/10.1371/journal.pone.0301155

                For further information, please contact Estela at e.capelasbarbosa@bristol.ac.uk

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                VISION Policy Briefing: Domestic violence and abuse and mental and physical health

                  Domestic violence and abuse (DVA) is prevalent within the United Kingdom (UK) and has severe and long-lasting physical and mental health consequences. An estimated 2.3 million adults in England and Wales (4.8%) experienced domestic abuse in the past 12 months. More women than men experience DVA, and women experience more repeated abuse, more physical, sexual, and emotional violence and coercive control, more injuries, and greater fear.

                  We, in the VISION research consortium, investigate how DVA is related to health. This policy briefing summarises evidence from five of our recent publications. We highlight the key recommendation resulting from across the research and discuss the key findings and evidence demonstrating the prevalence of DVA and the need for a cross-government approach to violence prevention.

                  Key Recommendation

                  A cross-government approach to preventing violence needs to include health services, alongside justice, welfare, education and other sectors. An effective and safe NHS response to survivors of domestic violence needs to be implemented. That response, embedded in training for healthcare professionals and referral to appropriate services, stretches from identification of survivors to initial support, to addressing the mental health and other sequelae of violence. Currently, the response is sporadic and patchy, with many Integrated Care Boards (ICBs) not commissioning necessary services. Integrated commissioning, as recommended in the NICE guidelines, could help bridge silos and sectors. 

                  Key findings

                  • Domestic violence and abuse (DVA) affects the physical and mental health of victim-survivors.
                  • About half of people who attempted suicide in the past year had experienced violence from a partner at some point in their life, and one in four experienced violence from a partner in the preceding year 
                  • The type of intimate partner relationship and the type of violence and abuse affects the nature and level of physical and mental health consequences. 
                  • People who use violence against their partners also tend to have worse mental health, and mental health services present an opportunity for intervention with this group. 

                  To download the paper: VISION Policy Briefing: Domestic violence and abuse and mental and physical health

                  To cite: Blom, N., Davies, E., Hashemi, L., Obolenskaya, P., Bhavsar, V., & McManus, S. (2025). VISION Policy Briefing: Domestic violence and abuse and mental and physical health. City St George’s, University of London. https://doi.org/10.25383/city.28653212.v3

                  For further information, please contact Niels at niels.blom@manchester.ac.uk

                  Call for Frontiers in Sociology abstracts: Enhancing data collection and integration to Reduce health harms and inequalities linked to violence

                    Frontiers in Sociology is currently welcoming submissions of original research for the following research topic: Enhancing Data Collection and Integration to Reduce Health Harms and Inequalities Linked to Violence.

                    This edition is guest-edited by Dr Estela Capelas Barbosa (University of Bristol and the UKPRP VISION research consortium), Dr Annie Bunce (City St. George’s, UoL and the UKPRP VISION research consortium), and Katie Smith (City St. George’s, UoL / University of Bristol).

                    Submissions should focus on any of the following:

                    • advancing measurement approaches which emphasise cross-sector harmonisation to better evaluate interventions, address health inequalities, and reduce violence
                    • addressing any form of violence (e.g., physical, non-physical, technology-facilitated) and its impacts on health, social and economic well-being, and marginalised groups, considering intersections of age, gender, ethnicity, disability, and religion

                    Research using existing datasets or primary data (quantitative or qualitative), cross-sectoral and cross-disciplinary approaches (e.g., sociology, criminology, public health), and lived experience perspectives is encouraged.

                    Contributions may include conceptual reviews, methodological innovations, empirical studies and systematic reviews on themes such as health inequalities, intervention effectiveness, outcome measurement, data harmonisation, and linkage strategies.

                    Abstracts are due by 7th April 2025, and the deadline for manuscripts is 28th July 2025.

                    For details of the different article types accepted and associated costs, please follow this link https://www.frontiersin.org/journals/sociology/for-authors/publishing-fees.

                    For more information and to submit an abstract or manuscript, please use the “I’m interested” link below or visit the Research Topic page here https://www.frontiersin.org/research-topics/67291/enhancing-data-collection-and-integration-to-reduce-health-harms-and-inequalities-linked-to-violence. 

                    This special edition provides an excellent opportunity to advance knowledge in this critical area. Please do reach out and contact us if you have any questions: annie.bunce@city.ac.uk

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                    Implications of changing domestic abuse measurement on the Crime Survey for England & Wales

                      The Office for National Statistics (ONS) is making a major decision this month on the future of Crime Survey for England and Wales (CSEW) Domestic abuse measurement and monitoring.

                      Last year, ONS ran an experiment where half of the CSEW sample got the domestic abuse module used since 2005, and the other half got a new module that is not comparable with the previous one. ONS intend to move over entirely to the new module in the next data collection (2025/26).

                      Loss of the existing module has major implications: it is world-leading, uses globally comparable items, and with trend data going back to 2005. Without consistently administered core items from that module, it will no longer be possible to:

                      • Produce long-term trends over time in domestic abuse for England and Wales.
                      • Group a decade of survey years together to have enough cases to robustly examine domestic abuse in particular regions, minoritised groups, and by other protected characteristics for many years. This is essential for understanding inequalities in violence and subsequent service contact, and whether these are changing.

                      The new module is problematic for many reasons:

                      • Is not a standardised measure, has undergone little validation or psychometric testing, and is not comparable with anything used previously or in any other country or study.  
                      • It separates data collection between former and current partner based on relationship status at the time of the interview, not at the time of abuse. This distinction creates confusion for interpretation of analysis and may be misinterpreted. The distinction is also problematic for classification of casual and other relationship types.
                      • The overhaul of the module was intended to align measurement with the Domestic Abuse Act 2021 definition, but it appears that domestic abuse as recognised by that Act cannot be identified by this module.

                      We urgently recommend that before losing this world-leading time series and relying on an untested, not comparable, and flawed new approach to DA measurement in England and Wales, that ONS:

                      1. Pause: continue the split-sample data collection for one more year.
                      2. Test the new approach: fully compare data collected using the new and old modules data so the validity and utility of the new measures can be evaluated appropriately, and its impact on inequalities assessed.
                      3. Publish these results publicly: and fully consult once stakeholders understand all the implications of having data collected in each way before the decision to roll out new data collection is finalised.
                      4. With this information, then compare all options: such as maintaining some of the existing questions alongside adding new coercive control items. This straightforward approach would ensure the utility of the survey for national trends (in both England and Wales) and analysis of inequalities and minoritised groups, while also improving the measurement of coercive control.

                      We urge others who feel similarly to contact ONS at CrimeStatistics@ons.gov.uk  or contact us at VISION_Management_Team@city.ac.uk if you would like to discuss.

                      Note that ONS is planning a raft of further changes with similar implications for trends and analysis of minoritised groups, including:

                      • Removal of the sexual victimisation module from next data collection (2025/26), with redevelopment at some future date.
                      • Removal and redevelopment of the nature of partner abuse questions, which cover DA survivors service use and police contact and are essential to understanding whether some groups are underserved by services.

                      These will further undermine continuity of data for trends and the ability to analyse minoritised groups or by protected characteristics.

                      For researchers interested in combining CSEW waves to enable robust analysis of inequalities by protected characteristics and for minoritised groups, VISION researcher Niels Blom has published syntax: https://vision.city.ac.uk/news/new-possibilities-created-by-crime-survey-wave-integration/.

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